title: Behavioral problems in school-aged hearing-impaired children: the influence of sociodemographic, linguistic, and medical factors.
abstract: The purpose of this study was to examine several behavioral problems in school-aged hearing-impaired children with hearing aids or cochlear implants, compared to normally hearing children. Additionally, we wanted to investigate which sociodemographic, linguistic, and medical factors contributed to the level of behavioral problems, to pinpoint where targeted interventions can take place. This large, retrospective study included a sample of 261 school-aged children (mean age = 11.8 years, SD = 1.6), that consisted of three age- and gender-matched subgroups: 75 with hearing aids, 57 with cochlear implants, and 129 normally hearing controls. Self- and parent-reports concerning reactive and proactive aggression, delinquency, and symptoms of psychopathy, attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder were used. In addition, several language and intelligence tests were administered. Hearing-impaired children showed significantly more proactive aggression, symptoms of psychopathy, attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder than their normally hearing peers. More behavioral problems were associated with special schools for the deaf, sign (-supported) language, hearing aids (in contrast to cochlear implants), higher age, male gender, lower socioeconomic status, lower intelligence, and delayed language development. Hearing-impaired children face multiple problems regarding their behavior. The outcomes implicate that professionals should be aware of the higher risk of developing behavioral problems, in order to screen, detect, and treat in time. Furthermore, the associated risk and protective factors emphasize that clinicians must always consider the heterogeneity of the group of hearing-impaired children, in order to help and support the individual patient.
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands. s.c.p.m.theunissen@lumc.nl.
authors.forename: Stephanie C P M
authors.initials: SC
authors.lastname: Theunissen
authors.affiliation: Department of Developmental Psychology, Leiden University, Leiden, The Netherlands.|Dutch Foundation for the Deaf and Hard of Hearing Child, Amsterdam, The Netherlands.
authors.forename: Carolien
authors.initials: C
authors.lastname: Rieffe
authors.affiliation: Department of Developmental Psychology, Leiden University, Leiden, The Netherlands.
authors.forename: Maartje
authors.initials: M
authors.lastname: Kouwenberg
authors.affiliation: KIDS, Royal Institute for the Deaf, Hasselt, Belgium.
authors.forename: Leo J I
authors.initials: LJ
authors.lastname: De Raeve
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands.
authors.forename: Wim
authors.initials: W
authors.lastname: Soede
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands.
authors.forename: Jeroen J
authors.initials: JJ
authors.lastname: Briaire
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands.
authors.forename: Johan H M
authors.initials: JH
authors.lastname: Frijns
mesh_terms: D000374:Aggression; D000987:Antisocial Personality Disorder / Q000523:psychology; D001289:Attention Deficit Disorder with Hyperactivity; D019958:Attention Deficit and Disruptive Behavior Disorders; D016022:Case-Control Studies; D002648:Child; D003054:Cochlear Implants / Q000523:psychology*; D019955:Conduct Disorder; D005260:Female; D006310:Hearing Aids / Q000523:psychology; D034381:Hearing Loss / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D007805:Language Development Disorders; D008037:Linguistics; D008297:Male; D000066553:Problem Behavior / Q000523:psychology*; D012189:Retrospective Studies; D012307:Risk Factors; D012574:Schools
keywords: Behavioral problems; Children; Cochlear implant; Hearing impairment